Accessory Nerve Injuries
Accessory Nerve
Accessory Nerve Diseases
Nerve Transfer
Paralysis
Neck Dissection
Shoulder
Sciatic Nerve
Neck Muscles
Glossopharyngeal Nerve
Cranial Nerve Injuries
Scapula
Physical therapy for spinal accessory nerve injury complicated by adhesive capsulitis. (1/18)
BACKGROUND AND PURPOSE: The authors found no literature describing adhesive capsulitis as a consequence of spinal accessory nerve injury and no exercise program or protocol for patients with spinal accessory nerve injury. The purpose of this case report is to describe the management of a patient with adhesive capsulitis and spinal accessory nerve injury following a carotid endarterectomy. CASE DESCRIPTION: The patient was a 67-year-old woman referred for physical therapy following manipulation of the left shoulder and a diagnosis of adhesive capsulitis by her orthopedist. Spinal accessory nerve injury was identified during the initial physical therapy examination, and a program of neuromuscular electrical stimulation was initiated. OUTCOMES: The patient had almost full restoration of the involved muscle function after 5 months of physical therapy. DISCUSSION: This case report illustrates the importance of accurate diagnosis and suggests physical therapy intervention to manage adhesive capsulitis as a consequence of spinal accessory nerve injury. (+info)Levator scapulae and rhomboid transfer for paralysis of trapezius. The Eden-Lange procedure. (2/18)
Spinal accessory nerve palsy leads to painful disability of the shoulder, carrying an uncertain prognosis. We reviewed the long-term outcome in 16 patients who were treated for pain, weakness of active elevation and asymmetry of the shoulder and the neck due to chronic paralysis of the trapezius muscle, as a result of nerve palsy. Of four patients who were treated conservatively, none regained satisfactory function, although two became pain-free. The other 12 patients were treated operatively with transfer of the levator scapulae to the acromion and the rhomboid muscles to the infraspinatus fossa (the Eden-Lange procedure). At a mean follow-up of 32 years, the clinical outcome of the operatively treated patients was excellent in nine, fair in two, and poor in one patient, as determined by the Constant score. Pain was adequately relieved in 11 and overhead function was restored in nine patients. Pre-operative electromyography had been carried out in four patients. In two, who eventually had a poor outcome, a concomitant long thoracic and dorsal scapular nerve lesion had been present. The Eden-Lange procedure gives very satisfactory long-term results for the treatment of isolated paralysis of trapezius. In the presence of an additional serratus anterior palsy or weak rhomboid muscles, the procedure is less successful in restoring shoulder function. (+info)Accessory nerve injury. (3/18)
This article discusses a Supreme Court judgment involving an injury to the spinal accessory nerve which occurred during the excision of a lymph node mass in the posterior triangle of the neck.1 In this case, the medical practitioner was found to have been negligent for failing to diagnose the nerve injury in the postoperative period, and not for the actual injury to the nerve during the procedure. (+info)An unusual presentation of whiplash injury: long thoracic and spinal accessory nerve injury. (4/18)
Whiplash injuries from motor vehicle accidents are very common. The usual presentation and course of this condition normally results in resolution of symptoms within a few weeks. Brachial plexus traction injuries without any bone or joint lesion of the cervical spine have been reported before. We report a case where a gentleman was involved in a rear end vehicle collision, sustained a whiplash injury and was later found to have a long thoracic nerve palsy and spinal accessory nerve palsy. Although isolated injuries of both nerves following a whiplash injury have been reported, combined injury of the two nerves following a whiplash injury is very uncommon and is being reported for the first time. (+info)Surgical treatment of winged scapula. (5/18)
(+info)Spinal accessory nerve palsy following gunshot injury: a case report. (6/18)
Injuries to the spinal accessory nerve are rare and mostly iatrogenic. Pain, impaired ability to raise the ipsilateral shoulder, and scapular winging on abduction of the arm are the most frequently noted clinical manifestations. As a seldom case, a 20 year-old male with spinal accessory nerve palsy after penetrating trauma by gunshot was reported. Three months after the injury, he was complaining about left arm pain in abduction to shoulder level and a decreased range of movement. On physical examination, wasting of the left trapezium with loss of nuchal ridge and drooping of the shoulder were found. On neurological examination of the left trapezius and sternomastoid muscles, motor function were 3/5 and wide dysesthesia on the neck, shoulder and arm was present. The bullet entered just above the clavicle and exited from trapezium. Radiological studies were normal, where electromyography (EMG) showed neuropathic changes. Surgical exploration showed the intact nerve lying on its natural course and we performed external neurolysis for decompression. The postoperative period was uneventful. Dysesthesia has diminished slowly. He was transferred to physical rehabilitation unit. In his clinical control after 3 months he had no dysesthesia and neurological examination of the left trapezius and sternomastoid muscles motor function were 4/5. EMG showed recovery in the left spinal accessory nerve. (+info)Vernet's syndrome caused by large mycotic aneurysm of the extracranial internal carotid artery after acute otitis media--case report. (7/18)
An 85-year-old man presented with a rare large aneurysm of the extracranial internal carotid artery (ICA) due to acute otitis media manifesting as Vernet's syndrome 2 weeks after the diagnosis of right acute otitis media. Angiography of the right extracranial ICA demonstrated an irregularly shaped large aneurysm with partial thrombosis. The aneurysm was treated by proximal ICA occlusion using endovascular coils. The ICA mycotic aneurysm was triggered by acute otitis media, and induced Vernet's syndrome as a result of direct compression to the jugular foramen. Extracranial ICA aneurysms due to focal infection should be considered in the differential diagnosis of lower cranial nerve palsy, although the incidence is thought to be very low. (+info)Accessory nerve palsy. (8/18)
After apparently uncomplicated excision of benign lesions in the posterior cervical triangle, two patients had shoulder pain. In one, neck pain and trapezius weakness were not prominent until one month after surgery. Inability to elevate the arm above the horizontal without externally rotating it, and prominent scapular displacement on arm abduction, but not on forward pushing movements, highlighted the trapezius dysfunction and differentiated it from serratus anterior weakness. Spinal accessory nerve lesions should be considered when minor surgical procedures, lymphadenitis, minor trauma, or tumours involved the posterior triangle of the neck. (+info)Accessory nerve injuries refer to damage or trauma to the eleventh cranial nerve, also known as the accessory nerve. This nerve has both a cranial and spinal root, and it primarily controls the movement of some muscles in the neck and shoulder.
Injuries to the accessory nerve can result in weakness or paralysis of the affected muscles, leading to difficulty turning the head or lifting the arm. The severity of the symptoms depends on the extent and location of the injury. Accessory nerve injuries can occur due to various reasons, such as trauma during surgery (particularly neck or shoulder surgeries), penetrating injuries, tumors, or neurological disorders.
Treatment for accessory nerve injuries typically involves a combination of physical therapy, pain management, and, in some cases, surgical intervention to repair the damaged nerve. The prognosis for recovery varies depending on the severity and cause of the injury.
The accessory nerve, also known as the eleventh cranial nerve (XI), has both a cranial and spinal component. It primarily controls the function of certain muscles in the back of the neck and shoulder.
The cranial part arises from nuclei in the brainstem and innervates some of the muscles that help with head rotation, including the sternocleidomastoid muscle. The spinal root originates from nerve roots in the upper spinal cord (C1-C5), exits the spine, and joins the cranial part to form a single trunk. This trunk then innervates the trapezius muscle, which helps with shoulder movement and stability.
Damage to the accessory nerve can result in weakness or paralysis of the affected muscles, causing symptoms such as difficulty turning the head, weak shoulder shrugging, or winged scapula (a condition where the shoulder blade protrudes from the back).
The accessory nerve, also known as the 11th cranial nerve (CN XI), has both a cranial and spinal root and innervates the sternocleidomastoid muscle and trapezius muscle. Accessory nerve diseases refer to conditions that affect the function of this nerve, leading to weakness or paralysis of the affected muscles.
Some examples of accessory nerve diseases include:
1. Traumatic injury: Direct trauma to the neck or posterior scalene region can damage the spinal root of the accessory nerve. This can result in weakness or paralysis of the trapezius muscle, leading to difficulty with shoulder movement and pain.
2. Neuralgia: Accessory nerve neuralgia is a condition characterized by painful spasms or shooting pains along the course of the accessory nerve. It can be caused by nerve compression, inflammation, or injury.
3. Tumors: Tumors in the neck region, such as schwannomas or neurofibromas, can compress or invade the accessory nerve, leading to weakness or paralysis of the affected muscles.
4. Infections: Viral infections, such as poliovirus or West Nile virus, can cause inflammation and damage to the accessory nerve, resulting in weakness or paralysis.
5. Neuropathy: Accessory nerve neuropathy is a condition characterized by degeneration of the accessory nerve fibers due to various causes such as diabetes, autoimmune disorders, or exposure to toxins. This can result in weakness or paralysis of the affected muscles.
6. Congenital defects: Some individuals may be born with congenital defects that affect the development and function of the accessory nerve, leading to weakness or paralysis of the affected muscles.
Treatment for accessory nerve diseases depends on the underlying cause and can include physical therapy, medications, surgery, or a combination of these approaches.
Peripheral nerve injuries refer to damage or trauma to the peripheral nerves, which are the nerves outside the brain and spinal cord. These nerves transmit information between the central nervous system (CNS) and the rest of the body, including sensory, motor, and autonomic functions. Peripheral nerve injuries can result in various symptoms, depending on the type and severity of the injury, such as numbness, tingling, weakness, or paralysis in the affected area.
Peripheral nerve injuries are classified into three main categories based on the degree of damage:
1. Neuropraxia: This is the mildest form of nerve injury, where the nerve remains intact but its function is disrupted due to a local conduction block. The nerve fiber is damaged, but the supporting structures remain intact. Recovery usually occurs within 6-12 weeks without any residual deficits.
2. Axonotmesis: In this type of injury, there is damage to both the axons and the supporting structures (endoneurium, perineurium). The nerve fibers are disrupted, but the connective tissue sheaths remain intact. Recovery can take several months or even up to a year, and it may be incomplete, with some residual deficits possible.
3. Neurotmesis: This is the most severe form of nerve injury, where there is complete disruption of the nerve fibers and supporting structures (endoneurium, perineurium, epineurium). Recovery is unlikely without surgical intervention, which may involve nerve grafting or repair.
Peripheral nerve injuries can be caused by various factors, including trauma, compression, stretching, lacerations, or chemical exposure. Treatment options depend on the type and severity of the injury and may include conservative management, such as physical therapy and pain management, or surgical intervention for more severe cases.
A nerve transfer is a surgical procedure where a functioning nerve is connected to an injured nerve to restore movement, sensation or function. The functioning nerve, called the donor nerve, usually comes from another less critical location in the body and has spare nerve fibers that can be used to reinnervate the injured nerve, called the recipient nerve.
During the procedure, a small section of the donor nerve is carefully dissected and prepared for transfer. The recipient nerve is also prepared by removing any damaged or non-functioning portions. The two ends are then connected using microsurgical techniques under a microscope. Over time, the nerve fibers from the donor nerve grow along the recipient nerve and reinnervate the muscles or sensory structures that were previously innervated by the injured nerve.
Nerve transfers can be used to treat various types of nerve injuries, including brachial plexus injuries, facial nerve palsy, and peripheral nerve injuries. The goal of the procedure is to restore function as quickly and efficiently as possible, allowing for a faster recovery and improved quality of life for the patient.
Paralysis is a loss of muscle function in part or all of your body. It can be localized, affecting only one specific area, or generalized, impacting multiple areas or even the entire body. Paralysis often occurs when something goes wrong with the way messages pass between your brain and muscles. In most cases, paralysis is caused by damage to the nervous system, especially the spinal cord. Other causes include stroke, trauma, infections, and various neurological disorders.
It's important to note that paralysis doesn't always mean a total loss of movement or feeling. Sometimes, it may just cause weakness or numbness in the affected area. The severity and extent of paralysis depend on the underlying cause and the location of the damage in the nervous system.
Neck dissection is a surgical procedure that involves the removal of lymph nodes and other tissues from the neck. It is typically performed as part of cancer treatment, particularly in cases of head and neck cancer, to help determine the stage of the cancer, prevent the spread of cancer, or treat existing metastases. There are several types of neck dissections, including radical, modified radical, and selective neck dissection, which vary based on the extent of tissue removal. The specific type of neck dissection performed depends on the location and extent of the cancer.
In anatomical terms, the shoulder refers to the complex joint of the human body that connects the upper limb to the trunk. It is formed by the union of three bones: the clavicle (collarbone), scapula (shoulder blade), and humerus (upper arm bone). The shoulder joint is a ball-and-socket type of synovial joint, allowing for a wide range of movements such as flexion, extension, abduction, adduction, internal rotation, and external rotation.
The shoulder complex includes not only the glenohumeral joint but also other structures that contribute to its movement and stability, including:
1. The acromioclavicular (AC) joint: where the clavicle meets the acromion process of the scapula.
2. The coracoclavicular (CC) ligament: connects the coracoid process of the scapula to the clavicle, providing additional stability to the AC joint.
3. The rotator cuff: a group of four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) that surround and reinforce the shoulder joint, contributing to its stability and range of motion.
4. The biceps tendon: originates from the supraglenoid tubercle of the scapula and passes through the shoulder joint, helping with flexion, supination, and stability.
5. Various ligaments and capsular structures that provide additional support and limit excessive movement in the shoulder joint.
The shoulder is a remarkable joint due to its wide range of motion, but this also makes it susceptible to injuries and disorders such as dislocations, subluxations, sprains, strains, tendinitis, bursitis, and degenerative conditions like osteoarthritis. Proper care, exercise, and maintenance are essential for maintaining shoulder health and function throughout one's life.
The sciatic nerve is the largest and longest nerve in the human body, running from the lower back through the buttocks and down the legs to the feet. It is formed by the union of the ventral rami (branches) of the L4 to S3 spinal nerves. The sciatic nerve provides motor and sensory innervation to various muscles and skin areas in the lower limbs, including the hamstrings, calf muscles, and the sole of the foot. Sciatic nerve disorders or injuries can result in symptoms such as pain, numbness, tingling, or weakness in the lower back, hips, legs, and feet, known as sciatica.
Neck muscles, also known as cervical muscles, are a group of muscles that provide movement, support, and stability to the neck region. They are responsible for various functions such as flexion, extension, rotation, and lateral bending of the head and neck. The main neck muscles include:
1. Sternocleidomastoid: This muscle is located on either side of the neck and is responsible for rotating and flexing the head. It also helps in tilting the head to the same side.
2. Trapezius: This large, flat muscle covers the back of the neck, shoulders, and upper back. It is involved in movements like shrugging the shoulders, rotating and extending the head, and stabilizing the scapula (shoulder blade).
3. Scalenes: These three pairs of muscles are located on the side of the neck and assist in flexing, rotating, and laterally bending the neck. They also help with breathing by elevating the first two ribs during inspiration.
4. Suboccipitals: These four small muscles are located at the base of the skull and are responsible for fine movements of the head, such as tilting and rotating.
5. Longus Colli and Longus Capitis: These muscles are deep neck flexors that help with flexing the head and neck forward.
6. Splenius Capitis and Splenius Cervicis: These muscles are located at the back of the neck and assist in extending, rotating, and laterally bending the head and neck.
7. Levator Scapulae: This muscle is located at the side and back of the neck, connecting the cervical vertebrae to the scapula. It helps with rotation, extension, and elevation of the head and scapula.
The glossopharyngeal nerve, also known as the ninth cranial nerve (IX), is a mixed nerve that carries both sensory and motor fibers. It originates from the medulla oblongata in the brainstem and has several functions:
1. Sensory function: The glossopharyngeal nerve provides general sensation to the posterior third of the tongue, the tonsils, the back of the throat (pharynx), and the middle ear. It also carries taste sensations from the back one-third of the tongue.
2. Special visceral afferent function: The nerve transmits information about the stretch of the carotid artery and blood pressure to the brainstem.
3. Motor function: The glossopharyngeal nerve innervates the stylopharyngeus muscle, which helps elevate the pharynx during swallowing. It also provides parasympathetic fibers to the parotid gland, stimulating saliva production.
4. Visceral afferent function: The glossopharyngeal nerve carries information about the condition of the internal organs in the thorax and abdomen to the brainstem.
Overall, the glossopharyngeal nerve plays a crucial role in swallowing, taste, saliva production, and monitoring blood pressure and heart rate.
Cranial nerve injuries refer to damages or trauma to one or more of the twelve cranial nerves (CN I through CN XII). These nerves originate from the brainstem and are responsible for transmitting sensory information (such as vision, hearing, smell, taste, and balance) and controlling various motor functions (like eye movement, facial expressions, swallowing, and speaking).
Cranial nerve injuries can result from various causes, including head trauma, tumors, infections, or neurological conditions. The severity of the injury may range from mild dysfunction to complete loss of function, depending on the extent of damage to the nerve. Treatment options vary based on the type and location of the injury but often involve a combination of medical management, physical therapy, surgical intervention, or rehabilitation.
The scapula, also known as the shoulder blade, is a flat, triangular bone located in the upper back region of the human body. It serves as the site of attachment for various muscles that are involved in movements of the shoulder joint and arm. The scapula has several important features:
1. Three borders (anterior, lateral, and medial)
2. Three angles (superior, inferior, and lateral)
3. Spine of the scapula - a long, horizontal ridge that divides the scapula into two parts: supraspinous fossa (above the spine) and infraspinous fossa (below the spine)
4. Glenoid cavity - a shallow, concave surface on the lateral border that articulates with the humerus to form the shoulder joint
5. Acromion process - a bony projection at the top of the scapula that forms part of the shoulder joint and serves as an attachment point for muscles and ligaments
6. Coracoid process - a hook-like bony projection extending from the anterior border, which provides attachment for muscles and ligaments
Understanding the anatomy and function of the scapula is essential in diagnosing and treating various shoulder and upper back conditions.
Iatrogenic disease refers to any condition or illness that is caused, directly or indirectly, by medical treatment or intervention. This can include adverse reactions to medications, infections acquired during hospitalization, complications from surgical procedures, or injuries caused by medical equipment. It's important to note that iatrogenic diseases are unintended and often preventable with proper care and precautions.
Accessory nerve
Accessory nerve disorder
Trapezius
Glenn Davis (baseball)
Eden-Lange procedure
Phrenic nerve
Nerve point of neck
Winged scapula
Sternocleidomastoid muscle
Posterior triangle of the neck
Jugular foramen
List of neuromuscular disorders
Cystohepatic triangle
Mandibular canal
Flexor pollicis longus muscle
Teres minor muscle
Lesser occipital nerve
Hypoglossal nerve
Cranial nerve disease
Cranial nerves
Diastematomyelia
Trochlear nerve
Phacoemulsification
Neck
Brachial plexus
Vagus nerve
Cervical plexus
Nav1.8
Nav1.7
Anconeus muscle
Accessory Nerve Injury: Practice Essentials, History of the Procedure, Problem
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Brachial plexus10
- Scapular winging, muscle weakness, chronic discomfort, and overall impairment of shoulder function are commonly caused by injuries to and/or compression of the upper brachial plexus, long thoracic, and accessory nerves. (surgicalneurologyint.com)
- Patients underwent unilateral decompression, neurolysis of the upper brachial plexus/long thoracic nerve (LTN), and partial resection of the scalene muscle. (surgicalneurologyint.com)
- Shoulder disability in adults: improvements after decompression and neurolysis of the upper brachial plexus and long thoracic nerves with partial resection of the scalene muscles. (surgicalneurologyint.com)
- BACKGROUND: Obstetric brachial plexus injury (OBPI) is a weakening or paralysis of the upper arm caused by brachial plexus injury followed by a muscle paralysis with severe repercussions on the movement of the shoulder joint following a progressive glenohumeral joint deformity. (bvsalud.org)
- We present our initial experience of double fascicular nerve transfer for upper brachial plexus avulsion. (thenerve.net)
- 8 ) reported the technique of nerve transfer from a redundant fascicle of the ulnar nerve to the biceps brachii branch of the musculocutaneous nerve for restoration of elbow function due to upper brachial plexus avulsion. (thenerve.net)
- Despite pain surgery for neuropathic pain in brachial plexus avulsion 5 , 9 , 10 ), no surgical restoration of the function of the elbow and shoulder was possible because it was referred to the authors one year after a shoulder injury. (thenerve.net)
- Finally, the authors had an opportunity to identify and treat brachial plexus avulsion in a patient who presented with pain and paralysis in the left arm within 1 year of the injury. (thenerve.net)
- The long thoracic nerve supplies the serratus anterior muscle via three spinal nerve roots, which cut through the clavicle area to the right of the brachial plexus. (cers-deutschland.org)
- The authors report the functional outcomes after functioning free muscle transfer (FFMT) for restoration of the upper-extremity movement after brachial plexus injury (BPI). (medscape.com)
Motor nerves3
- Anatomic study of the SAN has long maintained a debate as to the exact contributions of this nerve and other cervical motor nerves to the innervation of the trapezius muscle. (medscape.com)
- Neurotization of the donor muscle was performed using the musculocutaneous nerve (one case), spinal accessory nerve (12 cases), or multiple intercostal motor nerves (16 cases). (medscape.com)
- Both single and double free muscle transfer procedure were performed using extraplexal donor motor nerves. (medscape.com)
Vagus9
- The cranial component rapidly joins the vagus nerve, and there is ongoing debate about whether the cranial part should be considered part of the accessory nerve proper. (wikipedia.org)
- Leaving the skull, the nerve travels through the jugular foramen with the glossopharyngeal and vagus nerves. (wikipedia.org)
- Traditionally, the accessory nerve is described as having a small cranial component that descends from the medulla and briefly connects with the spinal accessory component before branching off of the nerve to join the vagus nerve. (wikipedia.org)
- After this the nerve routes through jugular foramen with vagus nerves and glossopharyngeal . (knowyourbody.net)
- Conventionally, it was considered that accessory nerve has a small cranial aspect that diminishes from the medulla and then connects with spinal accessory aspect before separating off to the nerve to link the vagus nerve. (knowyourbody.net)
- From the skull, it goes through the jugular foramen with the glossopharyngeal and vagus nerves. (knowyourbody.net)
- Once it leaves the skull, the cranial portion combines with CN X or the vagus nerve at the inferior ganglion. (knowyourbody.net)
- The afferent pathways include phrenic and vagus nerve and T6-T12 sympathetic fibers. (jmrionline.com)
- The efferent pathway comprises of the phrenic nerve (diaphragm), the vagus nerve (larynx) and spinal nerves (accessory muscles of inspiration) [ 4 ]. (jmrionline.com)
Phrenic Nerve3
- What is Phrenic Nerve? (mindmyfeed.com)
- The hiccup reflex is composed of the afferent pathway (through the vagal and phrenic nerves and the sympathetic chain), the central hiccup center (in the hypothalamus), and the efferent pathway (through the phrenic nerve to the diaphragm and the accessory nerves to the intercostal muscles). (lww.com)
- More invasive procedures include phrenic nerve block and vagal/phrenic nerve stimulation. (lww.com)
Believed to originate in the brain1
- It is classified as the eleventh of twelve pairs of cranial nerves because part of it was formerly believed to originate in the brain. (wikipedia.org)
Intraoperative nerve2
- In surgical procedures where the risk of accidental nerve damage is prevalent, surgeons commonly use electrical stimulation (ES) during intraoperative nerve monitoring (IONM) to assess a nerve's functional integrity. (nature.com)
- Continuous intraoperative nerve monitoring is useful for safe surgery in patients with possible inferior laryngeal nerve abnormalities. (bvsalud.org)
Trapezius muscle8
- The approach to management of SAN injury and trapezius muscle dysfunction is a multidisciplinary one that involves conservative management, physical therapy, and surgical repair. (medscape.com)
- In 1933, Bardeen suggested that the origin of motor input to the trapezius muscle was purely from the cervical nerves. (medscape.com)
- As it courses downwards, the nerve pierces through the sternocleidomastoid muscle while sending it motor branches, then continues down until it reaches the trapezius muscle to provide motor innervation to its upper part. (wikipedia.org)
- Right trapezius muscle atrophy and shoulder height discrepancy in spinal accessory nerve injury. (medlink.com)
- Sacrifice of the spinal accessory nerve results in denervation of the trapezius muscle (and sternocleidomastoid) as well as destabilization of the scapula. (medscape.com)
- Dissection immediately along the anterior border of the trapezius muscle can injure branches of the spinal accessory nerve as they dive toward the deep surface of the muscle. (medscape.com)
- During fine needle biopsy of the posterior triangle, the use of local anesthesia may eliminate spinal accessory nerve function so that the trapezius muscle does not contract upon penetration, and shoulder dysfunction can go unrecognized for hours until the anesthesia wears off. (medscape.com)
- Intra-operatively, the accessory nerve can become injured, even when it remains macroscopically intact, causing reduced trapezius muscle activity and weakness. (edu.au)
Shoulder dysfunction6
- Injury to the SAN results in varying degrees of shoulder dysfunction. (medscape.com)
- [ 5 ] SAN damage that results from radical neck dissection was first described by Ewing and Martin (1952), although Nahum (1961) coined the term "shoulder syndrome," describing the clinical syndrome of pain and shoulder dysfunction that is associated with SAN injury. (medscape.com)
- Accessory nerve shoulder dysfunction (ANSD) describes the pain and impaired range of motion that may occur following neck dissection. (edu.au)
- Studies have shown that any type of neck dissection can result in shoulder dysfunction, regardless of whether the spinal accessory nerve is preserved. (medscape.com)
- Shoulder dysfunction is also more likely be temporary in those who have less extensive spinal accessory nerve dissection. (medscape.com)
- Our literature review found that little evidence exists pertaining to the effectiveness of physiotherapy on accessory nerve shoulder dysfunction after neck dissection surgery exists, with only one previous randomised controlled study published. (edu.au)
Called the spinal acces2
- Consequently, the term "accessory nerve" usually refers only to nerve supplying the sternocleidomastoid and trapezius muscles, also called the spinal accessory nerve. (wikipedia.org)
- The first one is called the Spinal Accessory Nerve that originates in the neurons located in the upper spinal cord (medulla oblongata). (knowyourbody.net)
Jugular foramen3
- The nerve travels along the inner wall of the skull towards the jugular foramen. (wikipedia.org)
- The nerve moves near the inner wall of the skull near the jugular foramen. (knowyourbody.net)
- From the jugular foramen, it then leaves the cranium and connects to the spinal portion of the main Accessory Nerve. (knowyourbody.net)
Cranial13
- Cranial nerve XI, the spinal accessory nerve (SAN), is vulnerable to injury, owing to its long and superficial course in the posterior cervical neck. (medscape.com)
- The accessory nerve, also known as the eleventh cranial nerve, cranial nerve XI, or simply CN XI, is a cranial nerve that supplies the sternocleidomastoid and trapezius muscles. (wikipedia.org)
- Traditional descriptions of the accessory nerve divide it into a spinal part and a cranial part. (wikipedia.org)
- The spinal accessory nerve is notable for being the only cranial nerve to both enter and exit the skull. (wikipedia.org)
- This is due to it being unique among the cranial nerves in having neurons in the spinal cord. (wikipedia.org)
- The lateral horn of high cervical segments appears to be continuous with the nucleus ambiguus of the medulla oblongata, from which the cranial component of the accessory nerve is derived. (wikipedia.org)
- Amongst the twelve pairs of the cranial nerve in the brain, the eleventh pair of cranial nerve (CN11) is called the Accessory Nerve. (knowyourbody.net)
- It is a cranial nerve that serves the trapezius and sternocleidomastoid muscles. (knowyourbody.net)
- It is deemed as the 11th muscle of twelve pairs of the cranial nerves, or just cranial nerve XI. (knowyourbody.net)
- The end part of high cervical segments seems to be regular with nucleus ambiguous from medulla oblongata, which is the area dividing the cranial part of the accessory nerve. (knowyourbody.net)
- The Spinal Accessory Nerve is a unique one that is it is known to be the only cranial nerve that enters and exits the skull. (knowyourbody.net)
- The cranial portion or the cranial Accessory Nerve is smaller than the Spinal Accessory Nerve. (knowyourbody.net)
- [ 9 , 4 ] In addition to perioperative stroke, serious complications that may develop after CEA include myocardial ischemia and infarction , hemodynamic instability, cranial nerve (CN) injuries, and bleeding resulting in neck hematomas and airway compromise. (medscape.com)
Anatomical1
- Know the anatomical danger zones of these nerves, but also appreciate that nerve location cannot be precisely identified by anatomic location due to extensive individual variability. (mhmedical.com)
Median10
- The median nerve crosses in front of the brachial artery at the middle of the arm from lateral to medial side, and passes along its medial side. (pulsus.com)
- In cubital fossa, structures lying from lateral to medial are tendon of biceps brachii, brachial artery and median nerve (TAN). (pulsus.com)
- No literature is available stating median nerve to be lateral to the brachial artery in the cubital fossa. (pulsus.com)
- In the present case, we found bilateral variations in the course of median nerve and brachial artery in the cubital fossa. (pulsus.com)
- Compression neuropathy of median nerve, vascular compression and injury to the median nerve during brachial catheterization can occur in such a case. (pulsus.com)
- A more subtle possibility is that the median nerve itself may become more susceptible to damage, and less able to cope with the 'normal' stresses of life in the carpal tunnel as a result of more widespread nerve disease. (carpal-tunnel.net)
- Another example of this might be the slightly contentious entity of 'double crush' syndrome in which it is suggested that a lesion in the neck predisposes the median nerve to carpal tunnel syndrome. (carpal-tunnel.net)
- Anatomy Carpal tunnel syndrome contains median nerve, flexor pollicis longus and flexor digitorum superficialis. (medicosplexus.com)
- After lesioning of the dorsal root entry zone due to painful avulsion, double fascicles (flexor carpi radialis and flexor carpi ulnaris) of the median and ulnar nerve) were transferred to the biceps brachii and brachialis branches of the musculocutaneous nerve to restore elbow flexion. (thenerve.net)
- The so-called 'double fascicular nerve transfer' entails a surgical transfer of the flexor carpi radialis (FCR) and flexor carpi ulnar (FCU) branches of the median and ulnar nerves to the biceps brachii and brachialis branches of the musculocutaneous nerve for functional restoration of elbow flexion 2 - 4 , 6 , 7 , 12 - 15 ). (thenerve.net)
Long Thoracic Ner1
- In addition, electrical evidence of long thoracic nerve injury usually is required to confirm the etiology of scapular winging as being caused by serratus anterior dysfunction. (cers-deutschland.org)
Cervical6
- Course of the spinal accessory nerve (SAN) in the posterior cervical triangle. (medscape.com)
- Subsequent anatomic study reported a possible plexus composed of both cervical nerves and contributions from the SAN that collectively provided trapezial motor innervation. (medscape.com)
- The classic and much-used Gray's Anatomy assigned cervical nerves to a proprioceptive sensory role, with only the SAN providing motor innervation to the trapezius. (medscape.com)
- 1 - 8 ] Injury to the long thoracic nerve (LTN), which arises from the roots of the fifth, sixth, and seventh cervical nerves (C5-C7), is the most common cause of scapular winging. (surgicalneurologyint.com)
- If axons are supplied by the eighth cervical nerve they supply the lowest digitations. (cers-deutschland.org)
- The innervation of serratus anterior is from cervical nerves five through seven in the form of the long thoracic nerve. (cers-deutschland.org)
Surgery27
- During the surgery the doctor severed a spinal accessory nerve. (aitkenlaw.com)
- Defendant Guen J., M.D. performed the surgery to remove the bracheocleft cyst and during the surgery severed Amelia R's spinal accessory nerve. (aitkenlaw.com)
- By the time the referral had occurred, it was too late to try to do any kind of nerve repair surgery. (aitkenlaw.com)
- Plaintiffs contend that Dr. Guen J. did not provide Amelia R. with informed consent of the potential danger of hitting the nerve at the time of the surgery and the risk that this entails including the major injury that it involves if indeed the nerve is hit. (aitkenlaw.com)
- At the Stanford Center for Peripheral Nerve Surgery, our goal is to capitalize on the expertise of specialists from multiple fields of medicine to develop a customized treatment plan to address the needs of each individual patient. (stanford.edu)
- The Center for Peripheral Nerve Surgery utilizes a multi-faceted research approach ranging from basic/translational research to clinical trials to clinical outcomes research. (stanford.edu)
- Stanford Health Care's Peripheral Nerve Surgery Program offers comprehensive diagnostic evaluation and testing, as well as leading-edge surgical techniques, provided by a highly specialized and experienced nationally-recognized team. (stanford.edu)
- Moreover, INIs are also a common source of medicolegal litigation with 60% of INI complications during thyroid surgery leading to malpractice lawsuits and 82% of cases of spinal accessory nerve injury resulting in patient compensation 17 , 18 . (nature.com)
- IONM seeks to preserve peripheral nerve function through electrical stimulation (ES) of at risk nerves throughout surgery and examining any changes in the amplitude and latency of the evoked signals that are indicative of damage. (nature.com)
- On February 22, 1995, Dr. Love wrote a letter to Dr. Josey in which he opined that Leftwich "sustained an injury to the accessory nerve most likely related to the neck surgery. (findlaw.com)
- The mean time interval between the onset of injury and surgery was 2.3 years. (surgicalneurologyint.com)
- Anatomy Integrity of long thoracic nerve after damage due to surgery can be tested bedside by asking patient to raise the arm above the head on the affected side. (medicosplexus.com)
- There are several types of bariatric surgical table accessories that are designed to provide support and safety for patients during surgery. (alimed.com)
- Additionally, armboards can help to prevent nerve damage, muscle strains, and other injuries that can result from unintended movement during surgery. (alimed.com)
- Peripheral Nerve Surgery in India is a technique that involves nerves outside of the central nervous system. (medsurgeindia.com)
- What Is Peripheral Nerve Surgery? (medsurgeindia.com)
- People with peripheral nerve problems, such as acute nerve injuries, entrapment neuropathies, and nerve sheath tumors, undergo peripheral nerve surgery in India to restore function and reduce pain and impairment. (medsurgeindia.com)
- More than 100 different injuries, diseases, and disorders can be treated using peripheral nerve surgery in India. (medsurgeindia.com)
- Who Is a Good Candidate for Nerve Surgery? (medsurgeindia.com)
- The primary aim of this thesis was to investigate accessory nerve injury related to neck dissection surgery, and the effectiveness of a biomechanically specific physiotherapy intervention compared to a control group. (edu.au)
- We then undertook a case control electromyography study, to investigate any scapular muscle activity differences following neck dissection surgery in patients with clinical signs of accessory nerve injury. (edu.au)
- The RCT provided evidence that a progressive scapular strengthening program is more effective than usual care, for patients with accessory nerve injury after neck dissection surgery, that need to rapidly improve their active shoulder abduction. (edu.au)
- Therefore, nerve transfer surgery to restore elbow and shoulder function is rarely reported. (thenerve.net)
- Two weeks after the first transfer surgery, the distal accessory nerve was transferred to the suprascapular nerve to ensure shoulder function. (thenerve.net)
- For shoulder function, it is recommended to perform radial nerve transfer at the time of the first surgery. (thenerve.net)
- The nerves at the greatest risk for injury during cutaneous surgery are the temporal and marginal mandibular branches of the facial nerve and the spinal accessory nerve. (mhmedical.com)
- During these surgical procedures, the long thoracic nerve is protected by your surgeon and proper surgical technique, but occasionally difficulties arise during surgery and the nerve may become injured. (cers-deutschland.org)
Carpal1
- Structural changes in the bony walls of the carpal tunnel resulting from injury or arthritis clearly have the capacity to physically narrow the tunnel. (carpal-tunnel.net)
Tendon1
- Concern was voiced about employees suffering possible nerve and tendon deterioration of the hand, wrist and elbow and low back sprains/strains. (cdc.gov)
Sensory4
- This explains the unpredictable motor and sensory deficits that arise from transection of the nerves to this muscle. (medscape.com)
- Nerve conduction velocity and electromyography examination reports were obtained for the patients to assess the regional sensory or motor loss of the nerve injury. (surgicalneurologyint.com)
- The term "phrenia" refers to a group of approximately thirty different species of sensory nerves or afferents. (mindmyfeed.com)
- [ 12 ] have described a method involving two FFMTs combined with additional motor and sensory neurotization in patients with four or five nerve root avulsions. (medscape.com)
Fibers5
- The spinal accessory nerve's fibers originate from the neurons located in the upper spinal cord. (knowyourbody.net)
- The fibers link to create roots, rootlets, and the spinal accessory nerve. (knowyourbody.net)
- The spinal accessory nerve is formed by fibers of lower motor neurons situated in the upper areas of the spinal cord. (knowyourbody.net)
- The fibers of the Spinal Accessory Nerve join together to form rootlets, roots, and the spinal Accessory Nerve itself. (knowyourbody.net)
- Axons, the fibers that make up peripheral nerves, are insulated by surrounding tissues. (medsurgeindia.com)
Surgical16
- This article reviews the important surgical landmarks and anatomic variations of the SAN, etiologies of SAN injury, and outcomes of surgical repair. (medscape.com)
- We utilize the latest diagnostic techniques and surgical strategies to restore function and minimize pain for patients with peripheral nerve disorders. (stanford.edu)
- By assessing nerve functionality throughout a surgical procedure, the risk of INI is greatly reduced and timely interventions can be made if damage occurs. (nature.com)
- Bariatric Surgical Table Accessories are designed to help ensure the safety of these patients as well as the success of the procedure. (alimed.com)
- In this blog, we will discuss everything you need to know about bariatric surgical table accessories, including features, benefits, and examples. (alimed.com)
- What Are Bariatric Surgical Table Accessories? (alimed.com)
- Bariatric surgical table accessories are designed to provide better positioning options, increased weight capacity, and more substantial support for larger patients. (alimed.com)
- All of these accessories are designed to work with different tables to meet the needs of both the patient and medical professional, with higher weight capacities and larger sizes than standard surgical table accessories. (alimed.com)
- The benefits of bariatric surgical table accessories are numerous, but most importantly, they improve patient safety and comfort. (alimed.com)
- These accessories are designed to securely hold the patient in the necessary position while in the operating room, which is especially important during lengthy surgical procedures. (alimed.com)
- The increased weight capacity of bariatric surgical table accessories ensures that larger patients are stable during the procedure, reducing the risk of injury. (alimed.com)
- While the accessories you choose will depend on the surgical procedure and the needs of your patient, below are some of the most common types to consider. (alimed.com)
- Surgical Table Straps are used to secure the patient in specific positions, allowing the surgical team to work more efficiently and effectively while minimizing the risk of injury to the patient. (alimed.com)
- How To Choose The Right Bariatric Surgical Table Accessories? (alimed.com)
- A team of people may be involved in the surgical treatment and rehabilitation of peripheral nerve damage. (medsurgeindia.com)
- A jury in New Haven Connecticut recently awarded a 58-year-old man $4.2 million for an injury incurred during a surgical procedure that was the result of a doctor's misdiagnosis. (syracusemedicalmalpracticelawyerblog.com)
Musculocutaneous nerve1
- Motor root avulsion of the C5 and C6 roots results in Erb palsy, with loss of supply to muscles innervated by the suprascapular nerve, axillary nerve, and musculocutaneous nerve 3 ). (thenerve.net)
Traumatic1
- Traumatic brachial plexopathies are a diverse and complex group of injuries that result in functional upper-extremity deficits ranging from weakness to complete paralysis. (medscape.com)
Neuropathy2
- Peripheral neuropathy is the result of damage to the peripheral nerves. (medsurgeindia.com)
- Peripheral neuropathy is a peripheral nervous system disorder that affects the nerves that connect the central nervous system (CNS) to the arms, feet, mouth, legs, hands, face, and internal organs. (medsurgeindia.com)
Supraclavicular1
- The supraclavicular nerves were identified and retracted laterally. (surgicalneurologyint.com)
Spine2
- The area between the bone and the spine houses Schmorl's nodes, which allow nerves from the spine to pass through the joint cavity and head to the brain. (mindmyfeed.com)
- Nerve endings of all bone structures in the human body, including the spine, contain Schmorl's nodes. (mindmyfeed.com)
Recurrent2
- Patients with aortic arch malformations may present with recurrent inferior laryngeal nerve abnormalities that require special attention. (bvsalud.org)
- This is a retrospective cohort study in which the oncological outcome (contralateral and regional recurrence) and the reoperation complications (recurrent nerve paralysis/paresis and hypoparathyroidism) were evaluated. (scielo.org)
Lower motor n1
- The fibres that form the spinal accessory nerve are formed by lower motor neurons located in the upper segments of the spinal cord. (wikipedia.org)
Axillary nerve1
- An additional nerve transfer (triceps branch of the radial nerve to the axillary nerve) was planned for shoulder function. (thenerve.net)
Diaphragm1
- Although hiccups are caused by a myriad of causes which are related to the injury and/or irritation to the neural pathways, they most frequently occur because of irritation to the stomach wall or diaphragm. (jmrionline.com)
Artery3
- The nerve was lateral to the artery. (pulsus.com)
- The left inferior laryngeal nerve was presumed to be the right inferior laryngeal nerve by confirming the location of the aortic arch and subclavian artery, and the presence of the ductus arteriosus on preoperative computed tomography. (bvsalud.org)
- Digital blocks with lidocaine with epinephrine are considered safe, though the clinician should avoid using more than 2 to 4 mL of anesthesia per digit, as the mass effect of the anesthetic volume added can lead to nerve and artery compression. (mhmedical.com)
Weakness2
- Injury can cause wasting of the shoulder muscles, winging of the scapula, and weakness of shoulder abduction and external rotation. (wikipedia.org)
- Injury to the LTN can cause weakness or paralysis of the SA muscle, which stabilizes the scapula and supports the shoulder abduction. (surgicalneurologyint.com)
Compression1
- Movement of the neck and back becomes difficult due to nerve compression. (mindmyfeed.com)
Facial1
- Facial nerve palsy and left ventricular failure and acute respiratory or hemodynamic compromise. (surgicalimpex.com)
Sheath1
- Our current research focuses on advanced imaging techniques such as Stimulated Raman Histology to develop improved intraoperative decision-making, attempting to understand the growth pattern of nerve sheath tumors (schwannomas and neurofibromas), and the evaluation of an approved device (Neurocap) for the treatment of nerve pain secondary to neuromas through a post-approval clinical trial. (stanford.edu)
Sternocleidomastoid5
- The spinal component of the accessory nerve provides motor control of the sternocleidomastoid and trapezius muscles. (wikipedia.org)
- The nerve fibres supplying sternocleidomastoid, however, are thought to change sides (Latin: decussate) twice. (wikipedia.org)
- The accessory nerve offers motion functions to the sternocleidomastoid muscles that extend from the neck and move to trapezius and then extends to the upper back and shoulder. (knowyourbody.net)
- The Accessory Nerve helps with motor control of the sternocleidomastoid and trapezius muscles. (knowyourbody.net)
- The nerve fiber sternocleidomastoid controls the action of turning the head. (knowyourbody.net)
Disorders1
- 4 Back pain and problems, which include disc disorders, sciatica and other conditions which result from injury or degenerative conditions, 1 are a large contributor to illness and disability in Australia, accounting for 4.5% of the total disease burden. (racgp.org.au)
Biceps2
- However, the importance of the brachial muscle in elbow flexion was subsequently confirmed and the technique for the transfer of double fascicular nerves to both the biceps brachii and brachialis muscles was introduced 7 ). (thenerve.net)
- Biceps and shoulder musculature reinnervation involving both nerve grafting and transfer techniques has resulted in reliable restoration of elbow flexion and shoulder abduction when the procedure is undertaken within 6 to 9 months of injury. (medscape.com)
Femoral1
- Skin overlying the region where a venous cutdown is made to access the great saphenous vein is supplied by femoral nerve. (medicosplexus.com)
Posterior6
- In the neck, the accessory nerve crosses the internal jugular vein around the level of the posterior belly of digastric muscle. (wikipedia.org)
- In the neck, the accessory nerve crosses the internal jugular vein around the level of the posterior belly of digastric muscle, in front of the vein in about 80% of people, and behind it in about 20%, and in one reported case, piercing the vein. (wikipedia.org)
- The necessary nerve intersects the interior jugular vein across the level of posterior belly of the digastric muscle. (knowyourbody.net)
- The spinal accessory nerve can sometimes lie superficial enough in the posterior triangle to be at risk during elevation of skin flaps. (medscape.com)
- Also, during excisional biopsies of the posterior triangle, the spinal accessory nerve can be found to run directly over the enlarged lymph node. (medscape.com)
- posterior thoracic nerve) supplies the serratus anterior muscle. (cers-deutschland.org)
Stimulation1
- Hormonal imbalance with excessive estrogen stimulation is associated with the etiology of MBC, which occurs in men with undescended testes, congenital inguinal hernia, orchiectomy, orchitis, testicular injury, infertility and Klinefelter's syndrome. (gotoper.com)
Palsy2
- According to the suit, plaintiff now has nerve palsy, permanent disfigurement of his left shoulder, an inability to extend that arm or raise it above his head, permanent numbness and pain, and he can no longer work at his job without considerable difficulty. (syracusemedicalmalpracticelawyerblog.com)
- Like most of the Firm's New York birth injury lawsuits , the plaintiffs alleged that a group of medical defendants, including an obstetrician and a hospital (through its labor and delivery nurses and medical residents), were negligent in their collective (1) failure to diagnose fetal distress and (2) respond by performing a cesarean section before the baby suffered permanent brain damage, including spastic cerebral palsy, blindness and deafness. (syracusemedicalmalpracticelawyerblog.com)
Muscles3
- Strength testing of these muscles can be measured during a neurological examination to assess function of the spinal accessory nerve. (wikipedia.org)
- However, dysfunction is more frequent and severe for patients in whom the spinal accessory nerve is either resected or extensively dissected along its length from the skull base to the trapezius muscles. (medscape.com)
- The brain's ability to interact with muscles and organs can be harmed by a nerve injury. (medsurgeindia.com)
Graft1
- In the case of root avulsion, the absence of proximal nerve stump prevents nerve graft reconstruction and no spontaneous recovery of the shoulder and elbow function is anticipated 13 ). (thenerve.net)
Upper1
- The fibres of the spinal accessory nerve originate solely in neurons situated in the upper spinal cord, from where the spinal cord begins at the junction with the medulla oblongata, to the level of about C6. (wikipedia.org)